An 8-year-old girl presents with a history of normal vocabulary and grammar skills, but she is unable to use language to share ideas and feelings. Beginning in early childhood, she has been unable to make good eye contact and has difficulty reading social cues. These characteristics have led to difficulty making friends. Her social skills are further complicated by her obsession with light bulbs, which she repetitively draws on virtually any piece of paper she can find. She excessively smells shiny objects that catch her eye. She has rituals for getting dressed that cause significant distress if they are interrupted in any way. All of these symptoms have caused significant impairment in her functioning. What diagnosis best fits her presentation?
Autism spectrum disorder
Rett syndrome
Intellectual disability
Social communication disorder
The Correct Answer is A
Choice A reason: This is correct. The child exhibits core features of autism spectrum disorder (ASD), including deficits in social communication, restricted and repetitive behaviors, and sensory interests (smelling shiny objects), leading to functional impairment.
Choice B reason: Rett syndrome primarily affects girls and involves regression in motor skills and language after a period of normal development, which does not match this presentation.
Choice C reason: Intellectual disability involves deficits in intellectual and adaptive functioning across multiple domains. This child has normal intellectual abilities, as evidenced by vocabulary and grammar skills, making intellectual disability less likely.
Choice D reason: Social communication disorder involves difficulties with social use of language but does not include repetitive behaviors or sensory interests, which are present here.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: The BDI is a self-report tool for depression in adults and is not validated for assessing children with ADHD or overlapping mood symptoms.
Choice B reason: The Child Behavior Checklist is a parent- and teacher-report questionnaire that evaluates behavioral and emotional problems in children. It is comprehensive and useful for assessing ADHD symptoms as well as comorbid mood disturbances in children.
Choice C reason: Connor's Parent Teacher Rating Scales specifically assess ADHD symptoms but may not fully capture depressive or mood-related symptoms, which are also present in this child.
Choice D reason: CDI 2 assesses depressive symptoms in children, but it does not evaluate ADHD symptoms, attention problems, or teacher-reported behavioral difficulties.
Correct Answer is C
Explanation
Choice A reason: Although structural imaging may show small variations in multiple regions, reduced thalamic volume alone is not consistently observed or diagnostic in ADHD.
Choice B reason: EEG findings in ADHD typically show increased, not decreased, slow-wave activity (especially theta waves), reflecting cortical underarousal. Therefore, this option is inaccurate.
Choice C reason: Reduced total brain volume is a consistent biological finding in ADHD. Neuroimaging studies show that children and adults with ADHD tend to have smaller total brain volume, particularly in the prefrontal cortex, basal ganglia, and cerebellum. These differences reflect delayed cortical maturation and reduced neural connectivity, which underlie impaired executive functioning, attention control, and impulse regulation.
Choice D reason: ADHD is associated with delayed cortical maturation rather than early maturation. The developmental lag particularly affects the prefrontal regions involved in planning, inhibition, and working memory.
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